Zusammenfassung
Aus Unwissen, Unsicherheit, Bequemlichkeit oder vermeintlicher Sparsamkeit heraus werden Empfehlungen zur Infektionsprävention bei der Anästhesie nicht immer beachtet. Die wichtigsten sind: 1. für die Inhalationsnarkosen: Filter in Beatmungssystemen zum Rückhalt von Erregern können die Kontamination des Beatmungssystems verhindern, so dass dessen Aufbereitung nur einmal täglich oder bei Kontaminationen an der Außenseite notwendig ist; 2. für die Regionalanästhesie: Tragen von sterilen Handschuhen und Mund-Nasen-Schutz sowie eines sterilen Kittels; 3. für die intravenöse Anästhesie: Einmalmaterial zur intravenösen Applikation von Substanzen ist nach jedem Patienten vollständig zu verwerfen. Rückschlagventile in Infusionsleitungen bieten keinen verlässlichen Schutz vor Kontaminationen des Systems. Restmengen von Parenteralia, die vom Hersteller zur einmaligen Anwendung an einem Patienten deklariert sind, sollen verworfen werden.
Die alkoholische Händedesinfektion ist die wichtigste Maßnahme zur Vermeidung von Transmissionen und nosokomialen Infektionen.
Abstract
Several reasons such as ignorance, convenience, or economical considerations might lead to disobeying basic hygiene measures in anaesthesia. The most important recommendations are for: 1. General anaesthesia: bacterial filters prevent breathing circuit contamination from patient’s expiratory secretions. This way reprocessing of reusable components is required only once a day or in case an external contamination has occurred; 2. Neuraxial blockade: use of sterile gloves, a surgical face mask, and a sterile gown is recommended; 3. Intravenous anaesthesia: equipment not manufactured for re-use may not be used for more than one patient under any circumstances. One-way-valves do not securely prevent retrograde contamination of the infusion system. Do not use multi dose vials unless declared by manufacturer.
Alcoholic hand disinfection is the most important measure in order to avoid nosocomial pathogen transmission and infection.
Schlüsselwörter
Empfehlungen - Prävention - nosokomial - Infektion - Anästhesie
Key words
Recommendation - prevention - nosocomial - infection - anaesthesia
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Dr. med. Ralf-Peter Vonberg
Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover
Carl-Neuberg-Straße 1 · 30625 Hannover
eMail: Vonberg.Ralf@MH-Hannover.de
